Factors influencing turnover intention among primary care doctors: a cross-sectional study in Chongqing, China

Tong Wen,Yan Zhang,Guo Tang,Xue Wang

doi:10.1186/s12960-018-0274-z

Tong Wen, Yan Zhang + Show 2 more

Open Access

https://doi.org/10.1186/s12960-018-0274-z

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Abstract

BackgroundThe intention to leave a job, known as turnover intention, among primary care doctors has a significant impact on primary health care service delivery. We investigated primary care doctors’ turnover intention and analysed associated factors involved in primary health facilities in Chongqing, China.MethodsA total of 440 doctors were interviewed, they were selected using a multi-stage stratified random sampling method. The survey instrument was a self-administered questionnaire which assessed socio-demographic and work-related characteristics, job satisfaction and turnover intention. The data were analysed using χ2 test, one-way analysis of variance, exploratory factor analysis and linear regression analysis.ResultsOur study found that 42.3% of the primary care doctors we sampled in Chongqing, China, intended to resign. Location, age, job title, doctor’s position level, work pressure and job satisfaction were associated with turnover intention. Job satisfaction included both employment-related job satisfaction (including “your chance of promotion”, “your rate of pay” and two other items) and satisfaction with the job itself (including “the freedom to choose your own method of working”, “your job safety” and two other items).ConclusionsImproving job satisfaction, in terms of salary, promotion and job safety, is crucial for reducing turnover intention among primary care doctors. Therefore, we suggest that the government increase its financial investment in primary care facilities, especially in less-developed areas, and reform incentive mechanisms to improve the job satisfaction of primary care doctors. The government should consider policies such as establishing a social pension programme for village-level doctors and providing more opportunities for job promotion among primary care doctors, especially township-level doctors. Attention should also be paid to the impact of rapid urbanization, which could lead to increased workload or increased opportunities for career development, thus affecting primary care doctors’ turnover intention.

Highlights

The intention to leave a job, known as turnover intention, among primary care doctors has a significant impact on primary health care service delivery
We found that 42.3% of primary care doctors in the study had high turnover intention, which is higher than the rate of community health practitioners in the five other provinces in China (38.7%) [35] and higher than village doctors in Xiangyang, a city in Hubei province of China (36.8%) [30], while a study from England showed that only 11.8% of primary care doctors had high turnover intention [12]
Our study showed that the turnover intention of primary care doctors in Chongqing, China, is high and is affected by different aspects of job satisfaction

Summary

Introduction

The intention to leave a job, known as turnover intention, among primary care doctors has a significant impact on primary health care service delivery. We investigated primary care doctors’ turnover intention and analysed associated factors involved in primary health facilities in Chongqing, China. Primary health care (PHC) is pivotal more than ever [1]. Primary care facilities are facing significant labour shortages worldwide [3]. Colleges (AAMC), the USA will face a shortage of between 7300 and 43 100 primary care physicians by 2030 [4]. Few young doctors are willing to devote themselves to primary health care, and many of those doctors already in practice are leaving [2]. Greater emphasis should be placed on the retention of primary care doctors

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Conclusion